Provider Demographics
NPI:1679089072
Name:WILLS, LINDSAY SEA (LLPC)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:SEA
Last Name:WILLS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 WADSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2457
Mailing Address - Country:US
Mailing Address - Phone:231-735-6969
Mailing Address - Fax:
Practice Address - Street 1:810 COTTAGEVIEW DR STE 102
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2392
Practice Address - Country:US
Practice Address - Phone:231-735-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016296101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health